Overall, by 2015, the latest year data was available, the U.S. has not yet met breast or colorectal cancer screening targets set by the CDC, except for groups with the highest educational attainment. Lung cancer screenings for people at risk remained low.
It sounds simple, but two of the best ways for doctors to improve cancer screening rates is by recommending it to patients and sending frequent reminders.
“That’s an important piece for providers to recognize. It’s really powerful, our ability as providers to talk to patients about cancer screenings,” said Dr. Laura Makaroff, senior vice president of prevention and early detection at the American Cancer Society.
Calling or emailing patients can be helpful. And having reminders in electronic health records and population management tools can prompt providers as well.
Some practices haven’t seen screenings return to pre-pandemic levels, fueling worries that patients could be diagnosed at later stages when cancer is harder to treat.
Screenings are still down about 30% compared with pre-pandemic levels at City of Hope of Orange County, said president Annette Walker.
The organization is using public service announcements, radio and digital ads to encourage people to come back in.
“The reason cancer centers are so worried is we know that COVID didn’t stop cancer. People are still getting cancer at the same rates,” she said. “We try to get out there and advocate to people to get your screening, but it’s still not back to normal.”
She said practices should consider extending their hours or opening on weekends to increase access for people who can’t come in during the day on weekdays.
“It may be more helpful to look differently at how we’re providing our services to some of these communities,” she said.
The CDC also recommends providing rides to and from appointments, offering mobile mammography vans or pick-up locations for stool samples, helping with childcare, offering translation services and assigning staff to helping patients identify and overcome barriers to screening.
The pandemic may have helped change the conversation around accessibility, with eventually more screenings moving into the home, experts say.
“One of the things we learned during the pandemic was how to make screening more accessible and more pandemic-proof,” said Phil Castle, director of the National Cancer Institute’s Division of Cancer Prevention.
The Food and Drug Administration is working with companies on at-home screening kits for cervical cancer.
“We need to consider other ways to screen people that doesn’t require a clinic,” Castle said.
For example, one study shows that sending take-at-home tests for colorectal cancer to patients helped increase screenings by more than 1,000 % when compared with a control group that only received a text message reminder about scheduling an in-person screening, according to a study published in February in the Journal of General Internal Medicine.
Researchers sent the tests to patients overdue for testing at a community health center that predominantly serves people of color.
Still, some factors determining whether patients get cancer screenings are out of a physician’s control.
Shortages of primary-care doctors and lack of insurance coverage are significant barriers to accessing screenings, experts say.
“We have much more to do on the policy side to build a system of care that supports all these best practices and allows providers to be able to provide the best care at the right time in the right place for all patients,” said the American Cancer Society’s Makaroff.